Anna Sheahan1, Gretchen Copeland2, Lauren Richardson2, Shelley McKay3, Alexander Chou4, N Esther Babady5, Yi-Wei Tang5, Farid Boulad4, Janet Eagan2, Kent Sepkowitz2, Mini Kamboj2. 1. Infection Control Program and Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: anna.e.dow@gmail.com. 2. Infection Control Program and Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY. 3. Department of Pediatric Nursing, Memorial Sloan Kettering Cancer Center, New York, NY. 4. Pediatric Oncology and Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY. 5. Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Abstract
BACKGROUND: Patients undergoing treatment for cancer with chemotherapy and hematopoietic stem cell recipients are at risk for severe morbidity caused by norovirus (NV). METHODS: We describe a NV outbreak on the Memorial Sloan Kettering Cancer Center's pediatric oncology unit. Stool testing for diagnosis of NV was performed by real-time polymerase chain reaction (PCR). RESULTS: Twelve NV cases occurred; 7 were hospital acquired. Twenty-five health care workers reported NV compatible illness. Patient-to-patient transmission occurred once. The practices of the Centers for Disease Control and Prevention were supplemented with electronic surveillance, surrogate screening for NV, and heightened cleaning. Two additional cases occurred after implementation of interventions. Long-term shedding was detected in 2 patients. CONCLUSION: We describe interventions for controlling NV on a pediatric oncology unit. High-risk chronic shedders pose ongoing transmission risks. PCR is a valuable diagnostic tool but may be overly sensitive. Surrogate markers to assess NV burden in stool and studies on NV screening are needed to develop guidelines for high-risk chronic shedders.
BACKGROUND:Patients undergoing treatment for cancer with chemotherapy and hematopoietic stem cell recipients are at risk for severe morbidity caused by norovirus (NV). METHODS: We describe a NV outbreak on the Memorial Sloan Kettering Cancer Center's pediatric oncology unit. Stool testing for diagnosis of NV was performed by real-time polymerase chain reaction (PCR). RESULTS: Twelve NV cases occurred; 7 were hospital acquired. Twenty-five health care workers reported NV compatible illness. Patient-to-patient transmission occurred once. The practices of the Centers for Disease Control and Prevention were supplemented with electronic surveillance, surrogate screening for NV, and heightened cleaning. Two additional cases occurred after implementation of interventions. Long-term shedding was detected in 2 patients. CONCLUSION: We describe interventions for controlling NV on a pediatric oncology unit. High-risk chronic shedders pose ongoing transmission risks. PCR is a valuable diagnostic tool but may be overly sensitive. Surrogate markers to assess NV burden in stool and studies on NV screening are needed to develop guidelines for high-risk chronic shedders.
Authors: Rishi Desai; Christal D Hembree; Andreas Handel; Jonathan E Matthews; Benjamin W Dickey; Sharla McDonald; Aron J Hall; Umesh D Parashar; Juan S Leon; Benjamin Lopman Journal: Clin Infect Dis Date: 2012-04-04 Impact factor: 9.079
Authors: Stefan Schwartz; Maria Vergoulidou; Eckart Schreier; Christoph Loddenkemper; Mark Reinwald; Martin Schmidt-Hieber; Willy A Flegel; Eckhard Thiel; Thomas Schneider Journal: Blood Date: 2011-04-12 Impact factor: 22.113
Authors: Amanda M Casto; Amanda L Adler; Negar Makhsous; Kristen Crawford; Xuan Qin; Jane M Kuypers; Meei-Li Huang; Danielle M Zerr; Alexander L Greninger Journal: Clin Infect Dis Date: 2019-08-30 Impact factor: 9.079